Video-based quantification of body movement during social interaction indicates the severity of negative symptoms in patients with schizophrenia

In schizophrenia, nonverbal behavior, including body movement, is of theoretical and clinical importance. Although reduced nonverbal expressiveness is a major component of the negative symptoms encountered in schizophrenia, few studies have objectively assessed body movement during social interaction. In the present study, 378 brief, videotaped role-play scenes involving 27 stabilized outpatients diagnosed with paranoid-type schizophrenia were analyzed using Motion Energy Analysis (MEA). This method enables the objective measuring of body movement in conjunction with ordinary video recordings. Correlations between movement parameters (percentage of time in movement, movement speed) and symptom ratings from independent PANSS interviews were calculated. Movement parameters proved to be highly reliable. In keeping with predictions, reduced movement and movement speed correlated with negative symptoms. Accordingly, in patients who exhibited noticeable movement for less than 20% of the observation time, prominent negative symptoms were highly probable. As a control measure, the percentage of movement exhibited by the patients during role-play scenes was compared to that of their normal interactants. Patients with negative symptoms differed from normal interactants by showing significantly reduced head and body movement. Two specific positive symptoms were possibly related to movement parameters: suspiciousness tended to correlate with reduced head movement, and the expression of unusual thought content tended to relate to increased movement. Overall, a close and theoretically meaningful association between the objective movement parameters and the symptom profiles was found. MEA appears to be an objective, reliable and valid method for quantifying nonverbal behavior, an aspect which may furnish new insights into the processes related to reduced expressiveness in schizophrenia.

Quality assurance of simulated patient feedback in communication training for fourth-year medical students

Introduction In our program, simulated patients (SPs) give feedback to medical students in the course of communication skills training. To ensure effective training, quality control of the SPs’ feedback should be implemented. At other institutions, medical students evaluate the SPs’ feedback for quality control (Bouter et al., 2012). Thinking about implementing quality control for SPs’ feedback in our program, we wondered whether the evaluation by students would result in the same scores as evaluation by experts. Methods Consultations simulated by 4th-year medical students with SPs were video taped including the SP’s feedback to the students (n=85). At the end of the training sessions students rated the SPs’ performance using a rating instrument called Bernese Assessment for Role-play and Feedback (BARF) containing 11 items concerning feedback quality. Additionally the videos were evaluated by 3 trained experts using the BARF. Results The experts showed a high interrater agreement when rating identical feedbacks (ICCunjust=0.953). Comparing the rating of students and experts, high agreement was found with regard to the following items: 1. The SP invited the student to reflect on the consultation first, Amin (= minimal agreement) 97% 2. The SP asked the student what he/she liked about the consultation, Amin = 88%. 3. The SP started with positive feedback, Amin = 91%. 4. The SP was comparing the student with other students, Amin = 92%. In contrast the following items showed differences between the rating of experts and students: 1. The SP used precise situations for feedback, Amax (=maximal agreement) 55%, Students rated 67 of SPs’ feedbacks to be perfect with regard to this item (highest rating on a 5 point Likert scale), while only 29 feedbacks were rated this way by the experts. 2. The SP gave precise suggestions for improvement, Amax 75%, 62 of SPs’ feedbacks obtained the highest rating from students, while only 44 of SPs’ feedbacks achieved the highest rating in the view of the experts. 3. The SP speaks about his/her role in the third person, Amax 60%. Students rated 77 feedbacks with the highest score, while experts judged only 43 feedbacks this way. Conclusion Although evaluation by the students was in agreement with that of experts concerning some items, students rated the SPs’ feedback more often with the optimal score than experts did. Moreover it seems difficult for students to notice when SPs talk about the role in the first instead of the third person. Since precision and talking about the role in the third person are important quality criteria of feedback, this result should be taken into account when thinking about students’ evaluation of SPs’ feedback for quality control. Bouter, S., E. van Weel-Baumgarten, and S. Bolhuis. 2012. Construction and Validation of the Nijmegen Evaluation of the Simulated Patient (NESP): Assessing Simulated Patients’ Ability to Role-Play and Provide Feedback to Students. Academic Medicine: Journal of the Association of American Medical Colleges

Video-based quantification of body movement indicates negative symptoms: a replication

Objective: In schizophrenia, abnormalities in nonverbal behaviors have always been considered as highly relevant. However, due to methodological limitations, nonverbal behavior was rarely quantified objectively. Recent methodological advances now allow a quantification of body movement from ordinary video recordings. We showed that patients’ objectively measured amount of movement in social role-play interactions was closely associated with their symptom profiles (Kupper, Ramseyer, Hoffmann, & Tschacher, Schizophrenia Research 2010). In the present study, a replication of these results in the context of semi-standardized PANSS (Positive and Negative Syndrome Scale) interviews was intended. Methods: 17 patients with schizophrenia were analyzed during the initial 15-min sequence of a videotaped PANSS interview using Motion Energy Analysis (MEA). The amount of patients’ movement was then correlated with their PANSS symptom scores. Results: Sizeable and significant correlations between negative symptoms and reduced movements (r = -.68, p<0.01) and reduced movement speed (r = -.80, p<0.001) were found. Moreover, cognitive symptoms were related to reduced movement speed (r = -.70, p<.01). Conclusion: Negative symptoms were reliably indicated by patients’ nonverbal behavior in psychopathology interviews. Hence, the main result of our earlier study, examining patients’ nonverbal behavior in role play tests, was replicated for the less structured interactions in psychopathological interviews. Results could encourage the use of MEA in a wide range of videotaped social interactions of patients with schizophrenia and other psychiatric disorders.

La aplicación del componente pragmático funcional en un manual sueco de español publicado tras el currículo Lgy 2011

El objetivo de esta monografía es el de analizar el modo en el que un manual didáctico para la enseñanza del español en el contexto educativo sueco de bachillerato aplica y desarrolla la competencia pragmática funcional en sus propuestas didácticas. Para la realización de dicho análisis usaremos como instrumento de medida, por una parte, las actividades de simulación, escenario y role-play que propone Sánchez Sarmiento (2005), y que se dirigen a la activación de la competencia pragmática de los estudiantes de lenguas extranjeras y, por otra, los criterios de transacciones e interacciones de colaboración para el desarrollo de la competencia pragmática funcional que se recogen en el §.5 del Marco Común Europeo de Referencia para las lenguas: aprendizaje, enseñanza, evaluación (MCER, 2002). La hipótesis de la que parte este estudio postula que el manual que analizamos (Caminando 5, Natur & Kultur, 2013), a pesar de estar compuesto de propuestas didácticas en las que se presentan el componente pragmático funcional, no enuncia de forma explícita el trabajo con ella, no conduce ni a su activación ni a su desarrollo, su frecuencia de aparición en el manual es irregular, y las actividades que forman parte de sus propuestas didácticas no proponen reflexiones metapragmáticas sobre los propios contenidos pragmáticos de la lengua. La investigación que hemos desarrollado confirma que, aunque en algunas propuestas didácticas del manual  se proponen actividades que activan y desarrollan algunos de los criterios de transacción e interacción colaborativa del MCER (2002), su tratamiento resulta poco exhaustivo y su explicitación es escasa. Sin embargo, se puede constatar que el manual representa un acercamiento a los principios metodológicos de los enfoques comunicativos y que su explotación didáctica, aunque no de forma explícita, conduce, en parte, al trabajo con algunos de los criterios pragmáticos funcionales que se proponen en el MCER (2002).

Bridging the divide between theory and practice. Experiential learning approaches for tourism and hospitality education

Experiential learning approaches such as role-play have been found to be valuable methods of bridging the divide between academic knowledge and practical skills, a problem often cited in tourism and hospitality management education. Such approaches have been found to contribute towards deeper learning by enhancing students' interest, motivation, participation, knowledge and skill development. This paper reports on the implementation of an experiential learning approach designed to encourage and facilitate deeper learning approaches, with the contributing aims of providing students with a more interesting learning experience and a broader set of skills for future employment.

“Digital Diagnostics and Communication (DDC) system” Redesigning the Emergency Ambulance

During the development of a new treatment space for the UK emergency ambulance participatory observations with front-line clinicians revealed the need for an integrated patient monitoring, communication and navigation system. The research identified the different information touch-points and requirements through modes of use analysis, day-in-the-life study and simulation workshops with clinicians. Emergency scenario and role-play with paramedics identified 5 distinct ambulance modes of use. Information flow diagrams were created and checked by paramedics and digital User Interface (UI) wireframes were developed and evaluated by clinicians during clinical evaluations. Feedback from clinicians defined UI design specification further leading to a final design proposal. This research was a further development from the 2007 EPSRC funded “Smart Pods” project. The resulting interactive prototype was co-designed in collaboration with ambulance crews and provides a vision of what could be achieved by integrating well-proven IT technologies and protocols into a package relevant in the emergency medicine field. The system has been reviewed by over 40 ambulance crews and is part of a newly co-designed ambulance treatment space.

Video lectures and online activities to engage students in a flipped classroom

In recent years there have been several proposals for alternative pedagogical practices. Most of these proposals are based in the, so called, “active learning”, in opposition to the common “passive learning”, which is centered on transmission of information inside classrooms as well as recognized as teacher-centered procedure. In an active learning pedagogical structure, students have a more participative role in the overall learning/teaching process, being encouraged to face new learning challenges like, for instance, solving problems and developing projects, in an autonomous approach trying to make them, consequently, able to build their own knowledge. The flipped or “inverted” classroom is one of these active learning pedagogical methodologies that emphasizes a learner-centered instruction. According to this approach, the first contact that students have with the content on a particular curriculum subject is not transmitted by the lecturer in the classroom, this teaching strategy requires students to assess and analyze the specific subject before attending to class, therefore the informational component from the lecture is the homework, and class time is dedicated to exercises and assignments, always with support from the instructor, who acts as a facilitator, helping students when needed and offering supplementary explanation as required. The main objective of this paper is to discuss and explore how the use of different types of instructional videos and online activities may be implemented in the flipped classroom procedure (as means of incorporating new content and teaching new competencies) and to describe students’ perceptions of this approach within a course in a Higher Education Institution (HEI), presenting some positive and negative features of this pedagogical practice.

Enhancing Student Learning in Large Undergraduate Clasees by Using Audio-visual Case Studies

Critical skills such as identifying and appreciating issues that confront firms engaging in international business, and the ability to undertake creative decision-making, are considered fundamental to the study of International Business. It has been argued that using audio-visual case studies can help develop such skills. However, this is difficult due to a lack of Australian case studies. This paper reviews the literature outlining the advantages believed to result from the use of audio-visual case studies, describes a project implemented in a large cohort of students studying International Business, reports on a pilot evaluation of the project, and outlines the findings and conclusions of the survey.

A Delphi study to validate an advanced practice nursing tool

Aim This paper is a report of a study conducted to validate an instrument for measuring advanced practice nursing role delineation in an international contemporary health service context using the Delphi technique. Background Although most countries now have clear definitions and competency standards for nurse practitioners, no such clarity exists for many advanced practice nurse roles, leaving healthcare providers uncertain whether their service needs can or should be met by an advanced practice nurse or a nurse practitioner. The validation of a tool depicting advanced practice nursing is essential for the appropriate deployment of advanced practice nurses. This paper is the second in a three-phase study to develop an operational framework for assigning advanced practice nursing roles. Method An expert panel was established to review the activities in the Strong Model of Advanced Practice Role Delineation tool. Using the Delphi technique, data were collected via an on-line survey through a series of iterative rounds in 2008. Feedback and statistical summaries of responses were distributed to the panel until the 75% consensus cut-off was obtained. Results After three rounds and modification of five activities, consensus was obtained for validation of the content of this tool. Conclusion The Strong Model of Advanced Practice Role Delineation tool is valid for depicting the dimensions of practice of the advanced practice role in an international contemporary health service context thereby having the potential to optimize the utilization of the advanced practice nursing workforce.

Investigating and theorizing discourse during analogy writing in chemistry

Explanations of the role of analogies in learning science at a cognitive level are made in terms of creating bridges between new information and students’ prior knowledge. In this empirical study of learning with analogies in an 11th grade chemistry class, we explore an alternative explanation at the "social" level where analogy shapes classroom discourse. Students in the study developed analogies within small groups and with their teacher. These classroom interactions were monitored to identify changes in discourse that took place through these activities. Beginning from socio-cultural perspectives and hybridity, we investigated classroom discourse during analogical activities. From our analyses, we theorized a merged discourse that explains how the analog discourse becomes intertwined with the target discourse generating a transitional state where meanings, signs, symbols, and practices are in flux. Three categories were developed that capture how students intertwined the analog and target discourses—merged words, merged utterances/sentences, and merged practices.

Toward an in-depth understanding of cardiovascular interventional nursing : a qualitative study into nursing within the cardiac catheterisation laboratory setting

Introduction: Nursing in the cardiac catheterisation laboratory (CCL) varies globally in terms of scope and deployment. In the US, all allied staff are cross-trained into all CCL roles. The Australian and New Zealand experience has legislative frameworks that reserves specific functions to nurses. Yet, the nursing role within the CCL is poorly researched and defined. Aim: This study sought to gain deeper understanding of the perceived role of CCL nurses in Australia and New Zealand. Method: A descriptive qualitative study using semi-structured in-depth interviews was used. A cross-sectional sample of 23 senior clinical nurses or nursing managers representing 16 CCLs across Australia and New Zealand was obtained. Data were digitally recorded and transcribed verbatim prior to analysis by three researchers. Results: Five major themes emerged from the data. These themes were: 1. The CCL is a unique environment; 2. CCL nursing is a unique and advanced cardiac nursing discipline; 3. The recruitment attributes for CCL nurses are advanced; 4. Education needs to be standardised; and 5. The evidence to support practice is poor. Discussion: The CCL environment is a dynamic, deeply interdisciplinary setting with CCL nursing seen to be a unique advanced practice role. Yet the time has come for a scope of practice, educational standards, guidelines and competencies was expressed by the participants. Conclusion: Nursing in the CCL is an advanced practice role working within a complex interdisciplinary environment. Further work is required to define the role of CCL nurses together with the evidence-base for their practice.

How to Facilitate Open Disclosure Simulations

Open Disclosure comprises two main components: Clinician Disclosure (CD), an informal process usually conducted by the treating clinician; and Formal Open Disclosure (FOD), a more structured process led by a senior clinician trained as an Open Disclosure Consultant. Training programs for both CD and FOD incorporate interactive role-play based scenarios called ‘simulations’. This section of the Open Disclosure Training Program Handbook provides guidelines and resources for facilitating the simulation components of both Clinician Disclosure and Open Disclosure Consultant training.

Scaffolding reflective inquiry - enabling why-questioning while e-Learning

This paper presents some theoretical and interdisciplinary perspectives that might inform the design and development of information and communications technology (ICT) tools to support reflective inquiry during e-learning. The role of why-questioning provides the focus of discussion and is guided by literature that spans critical thinking, inquiry-based and problem-based learning, storytelling, sense-making, and reflective practice, as well as knowledge management, information science, computational linguistics and automated question generation. It is argued that there exists broad scope for the development of ICT scaffolding targeted at supporting reflective inquiry duringe-learning. Evidence suggests that wiki-based learning tasks, digital storytelling, and e-portfolio tools demonstrate the value of accommodating reflective practice and explanatory content in supporting learning; however, it is also argued that the scope for ICT tools that directly support why-questioning as a key aspect of reflective inquiry is a frontier ready for development.

Online video in education : acquisition, value & ROI

The session explores the potential for “Patron Driven Acquisition” (PDA) as a model for the acquisition of online video. Today, PDA has become a standard model of acquisition in the eBook market, more effectively aligning spend with use and increased return on investment (ROI). PDA is an unexplored model for acquisition of video, for which library collection development is complicated by higher storage and delivery costs, labor overheads for content selection and acquisition, and a dynamic film industry in which media and the technology that supports it is changing daily. Queensland University of Technology (QUT) and La Trobe University in Australia launched a research project in collaboration with Kanopy to explore the opportunity for PDA of video. The study relied on three data sources: (1) national surveys to compare the video purchasing and use practices of colleges, (2) on-campus pilot projects of PDA models to assess user engagement and behavior, and (3) testing of various user applications and features to support the model. The study incorporates usage statistics and survey data and builds upon a peer-reviewed research paper presented at the VALA 2014 conference in Melbourne, Australia. This session will be conducted by the researchers and will graphically present the results from the study. It will map out a future for video PDA, and how libraries can more cost-effectively acquire and maximize the discoverability of online video. The presenters will also solicit input and welcome questions from audience members.